Becky's story
Background
Becky had a very difficult childhood. She was developmentally delayed as an infant, with frequent temper tantrums and disturbed behaviours. Mainstream schooling was deemed unsuitable, so Becky was placed in special education. This may have gone some way to resolving her issues; however, at the age of 13, Becky was sexually assaulted by a neighbour.
This traumatic experience had a very deep impact on Becky, and was the start of many years of aggressive and challenging behaviours. In the years that followed, Becky was placed in numerous mental health care units but, whenever she was discharged, her behaviour would deteriorate so rapidly that she would be re-admitted very soon after.
The final straw for Becky was the death of her mother. Their relationship had been a close one, and her mother had been her main carer for her entire life. Finally, after a series of unmanageable outbursts, Becky was referred to Rowan House, one of Care Principles' secure hospitals, where she was assessed and admitted under Section 3 of the Mental Health Act with a legal classification of Mental Impairment.
Assessment, admission and treatment
Becky did not settle in easily at Rowan House, and displayed verbal and physical aggression, threats and intimidation, non-compliance with medication, self-injurious behaviour, damage to property and sexually offensive behaviour. She appeared to be settling in about six months after admission; however, in March 2004 she learned that her father had been hospitalised, after which her behaviour deteriorated.
By this stage, Becky’s behaviour was also starting to incorporate racial abuse and intolerance of newcomers to Rowan House.
A more emotional side to Becky would emerge on family visits. She enjoyed regular contact with her father, sister and brother-in-law; but these visits also emphasised her sadness and distress at not being able to see them more often. It was also clear that Becky was badly affected by her mother’s death. When she eventually allowed herself to talk about this, the staff at Rowan House taught her how to grieve properly, and incorporated coping skills in to her existing support programme.
Progress
The inclusion of coping skills and bereavement counselling seemed to mark a turning point in Becky’s behaviour: she could now use her emotions more positively, and was finally learning what safe and supportive relationships felt like. After a lengthy period of settled behaviour, it was jointly agreed with local services to look for a step-down placement nearer to home. Due to her long institutional history, a staged discharge process was agreed upon, incorporating gradual community exposure, before finally placing her in a supported living situation. A suitable step-down unit was found near to her family home and, after a series of successful visits and an overnight stay, Becky transferred to the new unit having spent 15 months at Rowan House. A few months after her discharge from Rowan House Becky was reported to be progressing very well: happier and more relaxed now that she was closer to her family, and becoming increasingly confident and sociable.
“It took a while to identify the right blend of treatments for Becky but, once we did, her progress was noticeable.”
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